A memorable case written upon the pages of medical history books is Karen Quilain whose parents went to court in order for doctors to remove her ventilator. She lived nine years after this health care intervention, dying from pneumonia (Quinlan, 1977). The health care practice here relates to removing life support. There have been countless research studies showing where blood transfusion practices have been detrimental to patients because either the blood was old or contaminated. Also, organ donation policies regarding the non-heart beating donor often resulted in patients’ relatives opting for donation without prior consent of the unconscious patient before the heart stops beating.
A practice that raises much concern among health care practitioners is the situation of the non-heart beat organ donation being practiced today as a measure to save life. Nancy Valko (2002) argues that the non-heart beat organ donation fad has become a dilemma facing not only health care professions, but the public at large being bombarded through advertisement to donate organs. These advertisements appeal to emotion is so strong that a picture of grieving relatives is always painted showing how relieved they are when an organ is donated for loves ones (Valko, 2002)
However, in the anxiety to extend life for a dying person many ethical boundaries are crossed when this happens in a manner whereby the legal rights of the donor is compromised through removal of organs before brain death occurs. Hence, the legal infiltrations of non-heart beating organ donation becoming a non ethical health care practice’ (Valko, 2002).
The health care intervention is very useful since many lives have been saved through these procedures, but the argument lies in how ethical is health care practice if patients’ rights are violated in the process. At any level whereby care is dispensed justice must motivate action as autonomous decisions are made. In response to these concerns further studies have revealed that when patients’ donor hearts do not stop breathing after orders have been given to remove ventilators, either the transplant is canceled or the patient returns to the ward to continue on the life support.
Health care professionals have a solemn responsibility when transfusing blood. According to studies conducted by Lassale (2008) blood transfusion is an act which enforces health care practitioners’ accountability for their intervention when administering such care. Precisely, the argument is that patients ought to be given correct information regarding the type of blood they would be receiving; the age of the blood as well as consent after authentic information is delivered to them (Lassale, 2008)
Doctors ought to write appropriate prescriptions that would ensure patients’ safety during and after transfusions since many complications or even death can occur when errors are encountered during the process. Lassale (2008) further emphasized that there must be a balance in the ‘beneficence and risk of therapy’ to ensure that patients do not suffer unduly through misinformation or inaccuracies during transfusion. Nurses were particularly cautioned to be vigilant towards their responsibility when setting up transfusions on patients.
The conflict in practice lies among many predisposing factors, which can implicate health care professionals during their patient care intervention. On many occasions ethical legal issues impinge on patients’ refusal of blood transfusion due to religions reasons. Lassale (2008) goes beyond such frivolity to discuss how healthcare violates ethical standards by offering misinformation; no information or inaccurate information to patients who do consent to having the transfusion(Lassale, 2008).
In the case of patient’s refusing blood transfusion this can conflict with health care practices, especially, if the patient dies. More importantly, it is fatal to transfuse blood which was not tested for all the impurities due to shortage of reagents in an effort to save the life of a hemorrhaging patient. These are some of the practices pertaining to blood transfusions for which Lassale (2008) argues conflict with professional ethics.
Removing life support
Many of these patients occupy the intensive care units of hospitals around the world. Some schools of thought contend that the cost of supporting futile life is overwhelming. As such, removing life support to end life is financially and, perhaps, politically sound too. But who decides whether life is futile or not? Is it the president, white house, court, health care professional, relatives or the patient themselves? On many occasions the patient cannot make that decision, but the person to whom surrogacy was assigned. Then, what if as in the case of Karen Quilain relatives wanted to remove life support, but health care professionals were not in agreement? The conflict lay between health care and the judicial system. Here is where removal of life support conflicts with healthcare practice. Health care is supposed to preserve life.
Further studies have revealed that intensive care is very expensive. According to John Luce and Gordon Rubenfield from “Department of Medicine, University of California, San Francisco, San Francisco, California; and Department of Medicine, University of Washington, Seattle, Washington” (Luce, 2002) of the $900+ billion expended on health care in 1995, 300+ billion went to hospital care of which 20% consisted of critical care allotment.( Luce & Rubenfield,2002), Clearly, the odds pertain towards the cost of keeping the life support machines going rather than exploring interventions to preserve life.
In critically analyzing these crucial health care practices the outsider as well as practitioner can feel the impact of what health care goals project and what actually is demonstrated in the health care arena across the world. People living in developed nations without adequate health insurance stand to suffer the most at unscrupulous health care delivery systems.
Health care practitioners are caught in the crossfire when patients have to be turned away due to lack of health insurance coverage or major life sustaining procedures cancelled due to lack of means to pay for it. Health care services are expected to provide total well being for individuals. These practices outlined in the foregoing pages of this document conflict with the specific intentions of health care as posited by world health organization. The resolution lays in affordable accessible healthcare for all.
Lassale B. (2008). Medical Responsibility. TransFus Clini-Biol.15 (5): 303-306.
Luce J, Rubenfield G(2002). Can Health care cost be reduced by limiting intensive care at the end of life? American Journal of Respiratory and critical Care medicine, 165. 6
Quinlan, J and Quinlan, J. D. (1977). Karen Ann: The Quinlans Tell Their Story. New York: Bantam Books.
Valko Nancy (2002). Ethical Implications of non-heart beating organ donation: Medicine and Morality Voices- Michaelmas. Volume XVII, No.3